Culture Change for Organisations – The macro

We specialise in helping organisations improve the culture of dementia care using best practice knowledge of contemporary dementia care and the insights of psychology at individual and organisational levels. This may be in short-term involvement such as a behaviour assessment or it may be in a longer term relationship in which we support and develop a culture of best-practice dementia care. Sometimes an individual assessment will lead to seeing that the issues are more systemic and the resident’s behaviour is a ‘symptom’ of the issues at unit, and/or site level.

The philosophy that underpins our approach is the person centred approach. This has care implications but it also affects the way an organisation conducts itself in hiring staff, inducting staff, developing staff, and letting staff go.

The person centred approach is based in a concept of respect for the personhood of each individual in the organisation, including the customer, or in the case of an aged care home the resident, their family, the staff and the management. Behavioural issues are often a result of multiple factors that require a broader focus than simply on the diagnosis of the individual person.

This form of consulting may be over 6-24 months and usually involve careful preparation and planning to ensure the goals of the project are consistent with the goals of the organisation and that there are sufficient resources and will to ensure success. The project team will engage with leaders in the organisation to arrive at a common understanding of the problems at issue and then devise a set of solutions and a process that is achievable in the organisation. We work to an evidence-based approach that uses clearly identifiable markers for success.

We also consult in relation to dementia care physical environments, providing CEOs, planners and architects, with advice about how to design physical environments that support a person with a cognitive impairment to live a life worth living. Engage us early to get it right. Alternatively we can give you advice on working with an existing physical environment so that you can remedy problems or enhance an already functioning unit to become a more homely place to live.

Individual assessments – The micro

We conduct comprehensive behaviour assessments for clients and residents with cognitive impairment in their own home and also in residential settings, and for those with long-term behavioural difficulties that are not related to cognitive impairment. Bernie McCarthy draws on his experience in aged psychiatry to construct a detailed picture of the behaviour, the person and the social and physical context in which the problem is occurring.

These evaluations usually involve a case discussion with managers or key staff, review of progress notes for the past several months, medication charts, behaviour charting, and care planning. If needed, family or others can have input to the review. The assessments usually take about two hours and the report takes about two to three hours to write.

Bernie can also consult via Skype on a one-off or regular basis. This can help build confidence in the staff to gradually think through the situations themselves independently. Behaviour assessments are usually funded by the aged care provider but may be funded by families of clients or residents.